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Degloving injury

José Couceiro, Mariangeles De la Red-Gallego, Luis Yeste, Higinio Ayala, Manuel Sanchez-Crespo, Olga Velez, Rebeca Barcenilla, Fernando Del Canto
The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Muhammad Amin Yousaf, Zain Ul Abidin, Kamran Khalid, Ata Ul Haq, Farrukh Aslam Khalid, Faraz Ahmad Tarar, Muhammad Umar Asif, Moazzam Nazeer Tarar
Obective:To assess the outcome of extended delayed reverse sural artery flap for reconstruction of foot defects proximal to toes in terms of flap survival, complication and extended area. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from February 2015 to April 2017. METHODOLOGY: Cases who underwent delayed sural artery flap were inducted. Preoperative hand-held doppler was done to confirm the location of perforator...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Ji H Son, Blaine Bafus, Anjay Khandelwal, Kyle J Chepla
Extensive degloving injuries of the upper extremity are rare and pose unique reconstructive challenges. Circumferential loss of soft tissue coverage over the elbow treated by skin grafting is often complicated by elbow contracture and decreased range of motion, requiring secondary contracture release and free-flap reconstruction to restore function. As an alternative approach, we report a good outcome after the use of a dermal regenerative template and subsequent split-thickness skin grafting. A 38-year-old right hand dominant man presented with circumferential degloving injury of the entire right upper extremity to the level of the chest wall after an industrial accident...
January 23, 2018: Techniques in Hand & Upper Extremity Surgery
Georgios Hatzichristodoulou
BACKGROUND: Correction of residual curvature during inflatable penile prosthesis (IPP) implantation in patients with Peyronie's disease (PD) by plaque incision and grafting is a common approach. AIM: To present a novel technique for residual curvature correction during IPP implantation using collagen fleece (TachoSil, Baxter Healthcare Corp, Deerfield, IL, USA). METHODS: After the IPP (Titan Touch, Coloplast, Minneapolis, MN, USA) is placed, the implant is inflated maximally...
January 8, 2018: Journal of Sexual Medicine
Yuebin Zhou, Honggang Guo, Zhiwei Cai, Yuan Zhang
RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO)...
December 2017: Medicine (Baltimore)
Hervé Monka Lekuya, Rose Alenyo, Isaac Kajja, Alexander Bangirana, Ronald Mbiine, Ater Ngoth Deng, Moses Galukande
BACKGROUND: Degloving injuries are surgical conditions in which an extensive portion of skin and subcutaneous tissue is detached from the underlying fasciae, muscles, or bone surface. Frequently, there is an association of fracture underlying the degloved area. We aimed to compare the short-term outcomes of degloving injuries with and without underlying fracture. METHODS: A prospective cohort study was conducted. We recruited patients with degloving injuries, and followed them up for 30 days to assess the outcomes...
January 5, 2018: Journal of Orthopaedic Surgery and Research
Abhishek Ghosh
Complex facial injuries with soft tissue degloving and bony avulsion are very devastating to the patient. Partial degloving injuries are described but hemifacial degloving with zygoma avulsion are rare. The author presents a case of post-traumatic degloving of the left upper lip, nose, part of forehead, upper and lower eyelids and cheek with avulsion of the left zygoma. The management included immediate resuscitation and early surgery to reposition the skeletal as well as soft tissue avulsion. The wound was thoroughly washed and primary repositioning and fixation were done...
September 2017: World Journal of Plastic Surgery
Murad Karadsheh, Josh Nelson, Benjamin Rechner, Richard Wilcox
Optimal wound healing with negative pressure wound therapy (NPWT) relies on a properly sealed vacuum system. Anatomically difficult wounds impair the adhesive dressing, which results in air leaks that disrupt the integrity of the NPWT system and hinder wound healing. OBJECTIVE: The authors demonstrate a new technique using a cyanoacrylate-based tissue adhesive to maintain an airtight, durable seal in NPWT. MATERIALS AND METHODS: A 52-year-old woman with a degloving injury to the right thigh extending into the groin, resulting in massive necrosis, presented to the emergency department...
November 2017: Wounds: a Compendium of Clinical Research and Practice
Yusuf Kenan Çoban, Özcan Öcük, Kaan Bekircan
Degloving hand injuries present challenging situations to hand surgeons as they present with difficulties in reconstructive microsurgery, particularly in multiple digital injuries. Time is a limiting factor when multiple degloving finger amputations are present. Thus, we proposed a repair method for multiple degloving finger injuries that involves coverage with a distal-based reverse forearm flap of all injured fingers in a two-stage procedure. Early vigorous physical therapy after pedicle division of the flap at postoperative third week eliminates joint stiffness problems at wrist and metacarpophalangeal joints...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Andrew Walls, Samuel E McMahon, Jonathan MacDonald, Jonathan Bunn
The Morel-Lavallée lesion is a closed degloving injury that usually occurs following high-energy trauma. We present a case demonstrating endoscopic management of this lesion. A 44-year-old man fell from scaffolding. Initial assessment demonstrated no significant injury. An ultrasound scan 2 days post injury revealed a large fluid collection along the lateral right thigh. This subsequently became infected and did not respond to antibiotic therapy.Due to the extent of the lesion, we were reluctant to perform a traditional open drainage...
September 23, 2017: BMJ Case Reports
Lindsay F Remy, Jacob Azurdia, Ashraf Fansa, Nabil A Ebraheim
Originally described in 1853 by Dr. Morel-Lavellee, closed internal degloving injuries represent an important, although uncommon, source of morbidity in trauma patients. These injuries are typically the result of a shearing or crushing force that traumatically separates the skin and subcutaneous tissue from the underlying fat. This results in disruption of perforating blood vessels and lymphatics, leading to hematoma/seroma formation. We describe two cases in which industrial crush injuries resulted in lumbar transverse process fracture...
July 2017: Archives of Bone and Joint Surgery
Ali J Electricwala, Jaffer T Electricwala
We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition...
2017: Case Reports in Emergency Medicine
Elamparidhi Padmanabhan, Ramesh Kumar Rudrappa, Talluri Bhavishya, Sibhithran Rajakumar, Sivaranjinie Selvakkalanjiyam
Morel-Lavallee lesions are closed degloving soft tissue injuries which occur because of trauma and in which the skin and subcutaneous tissue are separated from superficial fascia. This shear trauma results in creation of a potential space filled with serosanguinous fluid, blood and necrotic fat. We discuss a case of 52-year-old female with history of trauma one week back, who presented with a boggy swelling over the postero-lateral aspect of proximal forearm and distal arm. Local examination showed fluctuating fluid collection...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
Abdullah Merter, Mehmet Armangil, Burak Kaya, Sinan Bilgin
The car-tyre friction injury has differences from other injuries. The components of injury which are burn, crushing, shearing, and degloving occur. Many treatment options can be performed for coverage of wound which are Vacuum Assisted Closure system (V.A.C), skin grafting, free flaps, local flaps and cross leg flap.
2017: International Journal of Surgery Case Reports
Yoon Jae Lee, Jun Hyeok Kim, Ji Young Kim, Hyun Ho Han
The Morel-Lavallée lesion (MLL) is a post-traumatic closed soft tissue degloving injury. Common complaints of MLL patients are a haematoma or fluid collection on the trunk or the lower extremity. However, the authors introduce unique cases of MLL that present an atypical appearance. The fluid collection was not apparent, and the capsule formation was not detected on preoperative image study. The main complaint of patients was the uncomfortable mass-like lesion that was regarded as a simple benign lump. The purpose of this case study is to introduce the atypical cases of MLL and to help other physicians make accurate diagnosis based on trial and error of our cases...
December 2017: International Wound Journal
Audrey Falconi, Holly Crellin, Chelsea Tagawa
A Morel-Lavallee lesion (MLL) is a relatively rare condition that is caused by a traumatic shearing force. This force leads to a closed degloving injury of the subcutaneous tissue and fascia that creates a potential space that can fill with lymph, blood, and necrotic fat. The MLLs are traditionally seen after high impact trauma and typically located at the greater trochanter and pelvis, although recent reports have found them to be located at the knee, thigh, and lower leg. The MLLs typically present as swelling at the site of injury, which can be difficult to differentiate from several other diagnoses...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Ismail H Dilogo, Jessica Fiolin
INTRODUCTION: Percutaneous screw fixation is considered the best option in unstable pelvic fracture with severe soft tissue injury. However, fixation technique at the level of S3 has not been well established. This paper showed the feasible surgical technique of S3 screw insertion in unstable pelvic fracture with severe soft tissue injury. METHODS: We reported 2 cases of unstable pelvic injury of an 11 years old boy with Marvin-Tile (MT) C1 pelvic fracture with sacroiliac (SI) joint disruption, skin avulsion and Morel-Lavallée lesion...
2017: International Journal of Surgery Case Reports
Shanna A Matalon, Reza Askari, Jonathan D Gates, Ketan Patel, Aaron D Sodickson, Bharti Khurana
Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury)...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Steven K Wilson, Cesar Mora-Estaves, Paulo Egydio, David Ralph, Mohamad Habous, Christopher Love, Ahmad Shamsodini, Robert Valenzuela, Faysal A Yafi
OBJECTIVE: To examine possible etiology and treatment outcomes in 21 patients with glans necrosis following penile prosthesis implantation. METHODS: Glans necrosis typically presented with a dusky glans on the first postoperative day following prosthesis implantation. RESULTS: The blood supply to the glans penis consists of the dorsal arteries and the terminal branches of the spongiosal arteries. Using the cohort in our study, we compiled preoperative comorbidities and adjunctive surgical maneuvers that might compromise glans vascularity, leading to glans necrosis...
June 23, 2017: Urology
Jane Shelley, Alana Noritake, Kenneth Ortiz, Robert Ricca
Morel-Lavallee lesions (MLL) are closed degloving injuries that have been rarely described in the pediatric literature. These internal degloving injuries can have serious complications and long-term morbidity. Early diagnosis and intervention is imperative. We present the case of a 20-month-old with MLL of the thigh.
August 2017: Pediatric Surgery International
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